Expert: Trey McGowan - 6/23/2010

Question
QUESTION: I have contact with a 2 1/2 yr old boy whose primary vocalizations are simply syllables/sounds, not words, though he will say "Stop it" in a growly voice, and "No" Early Intervention is considering autism.  This child also witnessed severe domestic violence.  How does one distinguish between regression due to trauma, and regression symptomatic of autism?

ANSWER: Hi there, Dorothy!

In a case like that, a therapist or doctor is going to be the one to differentiate. Unfortunately, trauma regression isn't my specialty, so I have no idea about how to differentiate them. If there does seem to be some problems, though, then a therapist probably *should* be the one that you speak with about the whole thing, since severe domestic violence can have a lot longer-reaching problems than simply withdrawal.

I wish I could be of more help with this subject, but honestly this is definitely something that a specialist should be dealing with, rather than little ol' me: an AllExpert. As usual, though, any further questions, comments, feedback, follow-ups, are welcome!

Trey

---------- FOLLOW-UP ----------

QUESTION: What kind of therapist.  I am a trained mental health therapist, and under DSM IV criteria, I do not see symptoms of Autism, simply reluctance to use previously used language.  The child is interactive, makes eye contact, uses gestures to invite others to join in activities, plays peek-a-boo, smiles engagingly.  I do not see the stereotyped, or repetitive behaviors, and he is great at physical/mechanical problem-solving,and my diagnosis would be in the area of trauma response. Along with the language regression, he was partially potty trained prior to witnessing the violence, and almost immediately regressed to being back in diapers.  He uses more language at home than with early intervention staff from the educational setting.  As he becomes more comfortable in our setting, he is gradually using more words.  This would suggest more trauma foundation than Autism to me, but was unsure as to how an expert in Autism would see this combination of behaviors.

Answer
Hi again, Dorothy!

As a trained mental health therapist, you would know better than any that trying to make any sort of diagnosis without observation is not an option. In addition, though I am an AllExpert, I am not a doctor. I am not a clinically-trained therapist at all, and my expertise comes from personal experience, research, and education through a few specific individuals. This means that when it comes down to it, I'm simply not qualified to make a diagnosis.

I suggest that, as a clinical therapist, speaking with your peers would be the best suggestion I have. I expect that you would have a better idea of who to search for than even myself, through any contacts you have with your profession!

Questions? Comments? Feedback? Follow-ups? Feel free to ask!

Trey